云芝多糖防止缺血再灌注心肌早期损伤  

The Prevention of Experimental Myocardial Ischemia-Reperfusion Injury by Polysaccharide Krestin

作　　者：罗义[1] 刘伊丽 陈瑗[3] 查道刚 黄晓波 刘俭 

机构地区：[1]广州市第一人民医院心内科,广东省广州市510180 [2]第一军医大学南方医院心内科,广东省广州市510515 [3]第一军医大学自由基医学研究所,广东省广州市510515

出　　处：《中国动脉硬化杂志》2002年第2期125-128,共4页Chinese Journal of Arteriosclerosis

摘　　要：为了探讨云芝多糖对心肌缺血再灌注损伤的预防作用 ,制备犬心肌缺血再灌注损伤模型 ,缺血再灌注组不用药物干预 ,云芝多糖组手术前 2天每天口服云芝多糖 15 0mg kg。在缺血再灌注过程不同时间点测定左心室舒张压、超声心功能和冠状静脉窦血浆丙二醛浓度 ,心肌标本行透射电镜检查。结果发现 ,缺血再灌注组再灌注前和再灌注早期左心室舒张压显著升高 ,云芝多糖组仅再灌注前左心室舒张压升高。再灌注前两组缺血心肌节段收缩期增厚百分率显著下降 ,并表现为矛盾运动 ;再灌注期两组缺血心肌节段收缩期增厚百分率呈进行性改善 ,至再灌注 12 0min两组均未恢复至结扎前水平 ,且云芝多糖组显著高于相应时间点缺血再灌注组 ;左心室射血分数的变化趋势与缺血心肌节段收缩期增厚百分率相似 ,但恢复较快 ,云芝多糖组于再灌注 90min即恢复至结扎前水平。缺血再灌注组再灌注期丙二醛浓度明显升高 ,至再灌注 12 0min尚未恢复至结扎前水平 ,而云芝多糖组再灌注早期丙二醛浓度升高 ,但回降较快 ,于再灌注 30min即恢复至结扎前水平。缺血再灌注组心肌组织水肿 ,心肌细胞少部分肌丝断裂 ,收缩带模糊 ,线粒体轻度肿胀、脱颗粒 ,胞质水肿 ;云芝多糖组心肌组织除轻微水肿外 ,未见其它明显结构改变。结果提示 ,云芝多糖对缺血再?Aim To investigate the preventive effects of polysaccharide krestin (PSK) on myocardial ischemia reperfusion (I/R) injury. Methods Eight mongrel dogs of male, anesthetized with sodium pentobarbital, underwent 60 min of left anterior descending coronary artery occlusion, followed by 120 min reperfusion (I/R group). Another six dogs (PSK group) were subjected to the same ischemia reperfusion as I/R group, received PSK, which was administered orally, at a dose of 150 mg/kg once daily for two days before thoracotomy. Left ventricular function was evaluated by echocardiography using an echocardiogram and with measurement of left ventricular diastolic pressure (LVDP) by catheterization, and blood samples were taken from coronary venous sinus for the examination of malondialdehyde (MDA), at different time points. The ischemia reperfusion myocardium was examined pathologically. Results LVDP markedly rose before and in early reperfusion in I/R group, but only prior to reperfusion in PSK group. The systolic thickening of ischemia reperfusion myocardium region and left ventricular ejection fraction markedly declined during ischemia in both groups, but progressively improved with the time of reperfusion. In PSK group, the recovery of wall thickening was greater than in I/R group during reperfusion. Plasma MDA concentration during reperfusion in I/R group was higher than its baseline. In PSK group, MDA concentration rose only in early reperfusion, but recovered rapidly. In I/R group, myocardial cellular edema were present and, the fractures of a few myofilaments, the granule loss and swelling of mitochondrias were also seen. The ultrastructural abnormalities were much slighter in PSK group. Conclusion PSK could greatly alleviate the functional impairment and structural abnormalities of ischemia reperfusion myocardium.

关 键 词：心肌缺血 再灌注损伤 抗氧化剂 云芝多糖 

分 类 号：R542.2[医药卫生—心血管疾病]